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Home Topics Infectious Diseases Infections A-Z MERS-CoV General Information ›  Key facts - MERS-CoV

Key facts - MERS-CoV

Background information

Human coronaviruses were first identified in the mid 1960s and are named after the crown-like projections that can be seen on the surface of the virus. These viruses cause respiratory infections of varying severity in humans and animals. There are 3 main sub-groupings of coronaviruses, known as alpha, beta and gamma.



MERS-CoV (Middle East Respiratory Syndrome coronavirus virus), previously known as novel coronavirus, is a new subtype/strain of coronavirus, first identified by the Netherlands in 2012. Following its identification by the Netherlands, a genetically very similar strain was identified in a patient from the Middle East by Public Heath England’s’ virus reference laboratories at Colindale. The virus identified in the UK was fully sequenced and detailed analysis indicates that the nearest relatives are bat coronaviruses. At this stage, since only a relatively small number of cases have been reported, there is still little information on how it is spread, the range of illness it can cause and the source of the infection.


New cases reported to date

This new coronavirus was first identified in September 2012 in a patient who died from a severe respiratory infection in June 2012. As of 19 June 2013 there have been over than 60 cases detected globally – the majority of these in Saudi Arabia. However, this is a dynamic situation and more cases may be reported. In around half of the cases reported to date, the patients have died. For the latest case updates please refer to the WHO website [external link].


Main symptoms

Most cases of illness present with fever and cough that progress to a severe pneumonia causing shortness of breath and breathing difficulties. Renal problems have been a feature of some cases but at this point it is not clear whether this is a typical presentation. In small number of cases a diarrheal illness has been the first symptom to appear. Although most cases have been characterised by a severe illness, milder illness has been detected.



There is insufficient information to make generic treatment recommendations and patients have to be assessed on a case by case basis. This might include the use of specific antirvirals, antibiotics to prevent secondary infections and drugs to modulate the immune response. A treatment support tool has been developed based on a review of the recent experience of treating patients with SARS and pandemic flu.


How the infection is caught

The primary source of infection is still not known. There is growing evidence that the infection is spread by the fine droplets created when people cough and sneeze, in common with many other respiratory viruses such as the cold virus and influenza.

So far there is only evidence of limited, non-sustained person-to-person transmission. If the virus was easily spread, we would have expected to see many more cases linked to people caring for cases or in contact with them.

Given the severity of the illness caused by the virus it is considered prudent to use a high level of personal protective equipment when caring for any case with a confirmed diagnosis. Additional measures include isolation of the patient and barrier nursing.

Coronaviruses are fairly fragile and are unlikely to survive for long outside of the body - around 24 hours. They are easily destroyed by most detergents and cleaning agents.


Source of the infection

Some new infections may appear when an organism circulating in the animal population is introduced to human beings (zoonoses). Certain infections may cause mild disease in an animal species but more severe illness in people (and vice versa).
At this stage the origin is unclear, but studies of the virus’s genetic material suggest that bat coronaviruses are the nearest relatives.

At this stage the origin is unclear, but studies of the virus’s genetic material suggest that bat coronaviruses are the nearest relatives.


Vaccine availability

There is no vaccine available for this infection.


Laboratory testing

The main test for this particular coronavirus is a screening PCR test followed by a more specific confirmatory test. A number of laboratories in the UK can now carry out the screening test for this virus. Serological tests have also been developed that look for the presence of antibodies to the virus. These can be used to determine the spread of the virus in the community and whether people can be infected by the virus without showing any signs or symptoms of disease.


Travel advice to the Middle East

Given that there have only been a relatively small number of confirmed cases worldwide, people planning to travel to the Middle East should continue with their plans. Travel advice will be kept under review if additional cases occur or when the patterns of transmission become clearer. For the latest travel advice, please see the National Travel Health Network and Centre (NaTHNaC) website [external link].


Advice to travellers returning from the Middle East who become unwell

If symptoms are mild then they are probably due to a common respiratory virus such as the common cold. However if symptoms worsen and the illness started within 14 days of returning from the Middle East then medical help should be sought, either from your GP or NHS Direct/NHS 111 mentioning which countries in the Middle East were visited. Even with severe respiratory illness it is still most likely that the diagnosis will be one of the more common respiratory viruses, rather than MERS-CoV.



Severe acute respiratory syndrome (SARS) was caused by virus from the same family of conraviruses as MERS-CoV but a different unconnected subtype. A number of different viruses from the coronavirus family can cause illness in humans and animals ranging from mild symptoms such as the common cold to more serious respiratory illnesses.


Last reviewed: 4 October 2013